甲状腺功能亢进患者医嘱依从性与基础代谢率相关性分析

目的探讨甲亢患者医嘱依从性对基础代谢率的影响。方法确定观察因素和患者是否依从的标准,进行甲状腺大部切除术的甲亢患者96例分组,观察依从组和不依从组2周后基础代谢率降低值。结果依从组患者基础代谢率较不依从组患者降低明显,差异有统计学意义（P〈0.05）。结论提高医嘱依从性是甲亢患者术前准备降低基础代谢率的重要因素之一。     

整体护理对糖尿病患者治疗依从性的影响

目的：探讨整体护理对糖尿病患者治疗依从性的影响,为临床糖尿病的治疗提供参考。方法110例糖尿病患者随机分为观察组和对照组,每组55例,对照组给予常规护理,观察组给予整体护理,对两组患者的治疗依从性进行比较和分析。结果观察组完全依从及部分依从患者52例,对照组完全依从及部分依从患者26例,观察组依从性显著优于对照组,差异有统计学意义(P<0.05)。结论整体护理可有效提高糖尿病患者的治疗依从性及生活质量,值得临床推广。     

哮喘患者服药依从性现状及其影响因素

目的:分析哮喘患者服药依从性现状及其影响因素.方法:制定哮喘患者服药依从性的评定表,对患者服药依从性进行调查.结果:20例哮喘患者在住院期间,在护理人员监督和建议下都能服药依从,但出院后,服药依从仅12例,占60%,服药不依从患者8例,占40%.结论:对于任何需要长时间规律用药治疗的慢性病患者,可以从治疗依从性方面着手...     

药学服务对患者用药依从性的影响

目的分析药学服务对患者用药依从性的影响。方法将250例门诊药房取药患者随机分为研究组和对照组各125例。对照组采取传统取药服务模式,研究组采取新药学服务模式。对比2组患者的用药依从性。结果研究组完全依从率高于对照组,部分依从率和完全不依从率均低于对照组,差异均有统计学意义（P〈0．05）。结论药学服务对患者用药依从性有显著影响,提供高质量的药学服务,对于提升患者用药依从性有积极作用。     

精神分裂症药物治疗依从性的影响因素调查和护理对策

目的 探讨精神分裂症药物治疗依从性的影响因素和护理对策,以利于患者得到更好的治疗.方法 回顾性分析540例精神分裂症患者的临床资料,将用药完全依从者作为观察组,部分依从和不依从者作为对照组,比较两组患者在可能的影响因素上的差异.结果 540例患者中,完全依从210例,部分依从和不依从330例,年龄、文化程度、药物副反应、家属配合程度、医疗费用是否自费支付是影响杭精神分裂症药物治疗依从性的相关因素(P<0.05),与患者性别、病程、医患联系、抗精神分裂症药物应用时间无关(P>0.05).结论 影响抗精神分裂症药物治疗依从性的因素较多,应针对性采取相应措施提高患者的依从性.     

优质护理对慢性心力衰竭患者治疗依从性的影响

目的探讨优质护理干预对慢性心力衰竭患者治疗依从性的影响。方法将本院收治的94例慢性心力衰竭患者随机分至对照组(n=47例)和观察组(n=47例),对照组采取常规心内科护理,观察组在对照组基础上采取优质护理干预,比较2组患者的治疗依从性。结果对照组不依从9例,基本依从17例,完全依从21例,依从性为80.85%;观察组不依从3例,基本依从18例,完全依从26例,依从性为93.62%;经χ2检验,观察组的依从性显著高于对照组,P<0.05。结论在慢性心力衰竭患者中实施优质护理干预,能有效提高患者的治疗依从性。     

乙醇所致精神障碍患者治疗依从性与社会支持的关系

目的 探讨乙醇所致精神障碍患者治疗依从性与社会支持的关系.方法 调查49例乙醇所致精神障碍患者(高依从组32例和低依从组17例)的社会支持情况,分析其社会支持与治疗依从性的关系.结果 高依从组社会支持总分为(36.75±6.28)分高于低依从组的(31.98±7.16)分,差异有统计学意义(P＜0.01).结论 社会支持与乙醇所致精神障碍患者的治疗依从性密切相关;治疗护理过程中重视社会支持可以改善患者的依从性,减少复发.     

棕榈酸帕利哌酮治疗依从性的相关因素及其对精神分裂症患者复发的影响

目的调查分析棕榈酸帕利哌酮长效针剂(PP-LAI)治疗门诊精神分裂症患者的依从性及其对复发的影响。方法采用随访的方法,调查2013至2017年在成都市精神卫生中心就诊并使用PP-LAI的104例精神分裂症患者。通过用药依从性问卷和电话随访的方式收集测评患者的一般人口学资料、注射PP-LAI的治疗依从性以及53周随访期内的脱落情况。按照持续遵医嘱治疗或是自行断药将患者分为依从组和非依从组,其中依从组44例,非依从组60例。结果依从组和非依从组患者在性别、年龄、文化程度、社会功能和病程上的差异无统计学意义(P>0.05),在家庭人均月收入上的差异有统计学意义(P<0.05)。104例患者中,有26例出现复发,78例未出现复发。依从组复发2例,占4.5%,非依从组复发24例,占40%。Logistic回归结果显示,年龄[OR=1.059,95%CI(1.011,1.110),P=0.016]、学历[OR=1.629,95%CI(1.017,2.609),P=0.042]及家庭人均月收入[OR=0.454,95%CI(0.265,0.779),P=0.04]对于患者治疗依从性有显著影响。结论门诊精神分裂症患者PP-LAI治疗依从性不佳,年龄、学历和家庭人均月收入是影响患者治疗依从性的关键因素,依从性好的患者复发率较低。     

乙醇所致精神障碍患者治疗依从性与社会支持的关系

目的 探讨乙醇所致精神障碍患者治疗依从性与社会支持的关系.方法 调查49例乙醇所致精神障碍患者（高依从组32例和低依从组17例）的社会支持情况,分析其社会支持与治疗依从性的关系.结果 高依从组社会支持总分为（36.75±6.28）分高于低依从组的（31.98±7.16）分,差异有统计学意义（P＜0.01）.结论 社会支持与乙醇所致精神障碍患者的治疗依从性密切相关;治疗护理过程中重视社会支持可以改善患者的依从性,减少复发.     

健康教育对糖尿病患者治疗依从性的影响

目的研究强化健康教育对糖尿病患者治疗依从性的影响。方法对糖尿病患者进行强化健康教育,比较教育前后患者对治疗依从性。结果健康教育前药物治疗和复诊的依从率较好,分别为75%和63.9%;运动治疗的依从率低,为22.2%;饮食治疗的依从率差,为11.1%。健康教育后药物治疗和复诊率提高到94.4%和84.7%;饮食治疗和运动治疗的依从率提高到88.9%和80.6%。结论健康教育能有效提高糖尿病患者的治疗依从性,提高患者的生活质量。     

A computer model for the measurement of compliance using a dual tracer technique'pa

Aims We aimed to determine whether simultaneous use of two tracer compounds with long and differing elimination half-lives may permit more precise recognition of percent compliance and discrimination among remote, intermediate, and recent patterns of daily dosing.
Methods We have derived, through computer modelling, the potential utility of digitoxin and phenobarbitone as simultaneous tracers. From kinetic data on these reliably measured compounds with long half-lives we defined the percentage error below which this pair of tracers can be expected to discern the precise, and the approximate, pattern and number of daily doses taken over a month.
Results The longer the half-lives of the tracers the greater the sensitivity of our model to percentage compliance. At extremely long half-lives, relative to the period of dosing being monitored, sensitivity approaches 100% if measurement error is in the 1–2% range. The ratio of the half-lives between the two tracers that is optimal for detection of percentage compliance is 0.2 to 0.8. The detection of pattern does not depend importantly either on the tracer half-lives or on their ratio to each other. The greater the percentage compliance, the more accurately our two-tracer model determines the pattern of dosing.
Conclusions Precise characterization of compliance using tracers must probably await the development of compounds with half-lives measured in weeks or months. The probability of compliance of a given degree can be derived from our two-tracer technique with best-fit analysis such as we describe.     

Concurrent antibiotic-use review in a small hospital

A method of concurrent antibiotic-use review in a 60-bed pediatric hospital is described. The pharmacy department monitors appropriateness of antibiotic prescribing using criteria specified by the pharmacy and therapeutics committee. Antibiotic orders are reviewed by the pharmacist for compliance with the criteria at the time that the orders are written. At three-month intervals, information about the infections treated and the percentage compliance for all physicians, as well as for each individual physician, is compiled and reported to the pharmacy and therapeutics committee. Written and oral feedback are provided to each physician to further improve compliance. This comprehensive monitoring system has resulted in substantial improvement in antibiotic prescribing by physicians at this hospital.     

HIV感染者固定性伴侣暴露前预防用药临床试验依从性分析

目的了解HIV感染者固定性伴侣(PAR)暴露前预防用药(PrEP)临床试验的依从性及其可能的影响因素。方法采用非随机抽样筛选出163位PAR进入研究队列,随机决定其每日1次或每周2次服药方式,分别在第0、4、8、12、16、20、24、28周进行随访观察,从队列保持和药物漏服两个方面了解其依从性情况。利用χ~2检验进行单因素分析,多因素分析采用logistic回归分析。结果本次PAR人群PrEP临床试验中,79.8%(130/163)完成了28周的观察期,药物漏服者所占比例在随访期间始终波动在30%左右,平均每4周药物的漏服次数为2次,总体依从性得分(85.66±25.98)分,中位数97.40分。经logistic回归分析,影响队列保持的因素为年龄、月收入水平、试验期间是否有担心和困难、试验期间是否有医疗服务需求;影响药物漏服的因素为月收入水平、服药方式、随访管理模式、试验期间是否有担心和困难;影响总体依从性得分的因素为年龄、月收入水平、随访管理模式、试验期间是否有医疗服务需求。结论本次PAR人群PrEP临床试验的整体依从性高,影响因素多,在后续研究中应特别加强低年龄、高收入人群的依从性管理,并继续推广由专人随访的队列管理模式和不同特征个体分类管理,从而确保临床试验的高依从性。     

Actual versus prescribed timing of lovastatin doses assessed by electronic compliance monitoring

Summary The objective of the study was to compare compliance with and the hypocholesterolaemic effect of lovastatin given once daily as a morning or an evening dose. Twenty-four out-patients with familial hypercholesterolaemia were randomly assigned to receive placebo first, then lovastatin 20 mg, to be taken once daily for 4 weeks, either with the breakfast or evening meal, in a single-blind fashion.Drug compliance was assessed by pill counts and continuous electronic monitoring. Two compliance parameters were evaluated, consumption, defined as percentage of prescribed doses taken, and time compliance, the percentage of total dosing events recorded within defined intervals (6.00–10.00 h, and 17.00–21.00 h), for the morning and evening regimes.Both regimes satisfactorily reduced the total and LDL-cholesterol concentrations, and there was no significant difference in the extent of the reductions.Pill counts overestimated compliance, as revealed by the monitoring method. The times of actual consumption of doses by the patients often differed from that prescribed, predominantly in patients who were told to take the evening dose. Partial time compliance may have confounded the efficacy of the drugs. Electronic compliance monitoring appears to be particularly useful in chronopharmacological studies.Professor Ellen Weber died on 7th December 1992     

心血管门诊患者用药依从性的调查分析

目的:为制定改善心血管门诊患者用药依从性的措施提供参考。方法:采用问卷调查的方法收集数据,使用SPSS17.0软件对数据进行χ2检验和Logistic回归方法,分析影响心血管患者用药依从性的因素。结果:心血管门诊患者的用药依从性仅46.7%;其中性别、年龄、文化程度、职业状况、费用方式对用药依从性无影响;对病情的了解、对治疗重要性的认识、对药品的认识、用药种类、用药频次、家属的关心、医师的信任、药师的信任等均对用药依从性存在影响。结论:心血管门诊患者的用药依从性总体较差,应简化心血管疾病治疗方案,加强用药知识的宣传等措施,以提高患者的用药依从性。     

Assessment of Markov-dependent stochastic models for drug administration compliance

OBJECTIVE: There are few analytical results that describe patient compliance with drug administration regimens. The purpose of this paper is to develop and assess stochastic approaches for mathematical modelling of patient compliance with administration regimens. METHODS: Two stochastic models based on Markov-dependent random variables and on the Ising model were assessed for their ability to describe the variable nature of drug compliance. RESULTS: Both models use only experimentally accessible data, and their predictions were tested against published clinical compliance data obtained from electronic monitoring devices. The models satisfactorily fitted administration interval distribution data from several patients treated with diltiazem, a calcium channel antagonist, or zidovudine, an antiretroviral agent. The Ising model provides additional analytical expressions for the distribution of success runs and 'drug holidays' in administration regimens. These distribution predictions were tested with success run data for diltiazem and drug holiday data for two nonsteroidal anti-inflammatory drugs, piroxicam and tenoxicam. CONCLUSIONS: Stochastic models can provide useful insights into drug compliance, and can be used to identify the administration patterns that are more likely to occur during drug self-administration in populations.     

Multiple sclerosis patients treated with intramuscular IFN-β-1a autoinjector in a real-world setting: prospective evaluation of treatment persistence,adherence, quality of life and satisfaction

Objectives: The 12-month observational PERSIST study (NCT01405872) evaluated adherence associated with the intramuscular IFNβ-1a (i.m. IFN-β-1a) autoinjector pen in multiple sclerosis (MS) patients.

Methods: MS patients initiating i.m. IFN-β-1a autoinjector treatment were prospectively assessed for physician-reported persistence (percentage of patients remaining on therapy) and patient-reported outcomes, including adherence (percentage of unmissed injections), compliance (percentage of patients missing no injections), tolerability (injection-site reactions [ISRs] and pain) and satisfaction.

Results: The intent-to-treat population included 232 patients; of the 188 physician-reported 12-month completers, 182 patients remained on treatment (96.8% persistence). Monthly compliance rates were 87.5 – 96.2%. Mean monthly pain scores were 1.5 – 1.8 (scale: 0 = ‘no pain’; 10 = ‘extremely painful’). At 12 months, 73.5% of respondents reported no ISRs, 94.9% were satisfied/very satisfied with the autoinjector and 88.2% found using the device easy/very easy. Injection fear, injection anxiety and need for injection assistance by caregivers decreased from the initial visit to 12 months. No new safety signals were observed.

Conclusions: The autoinjector pen is associated with high levels of persistence, compliance, adherence, and satisfaction, little-to-no pain and low need for caregiver assistance. Although these data are limited by reliance on patient questionnaires and the absence of a direct comparator group, this treatment may reduce barriers to injection therapy, while supporting long-term MS management.     

The influence of dosing time, variable compliance and circadian low-density lipoprotein production on the effect of simvastatin: simulations from a pharmacokinetic-pharmacodynamic model

The aim of this study was to explore the influence of simvastatin dosing time, variable compliance and circadian cholesterol production on the reduction of low-density lipoprotein (LDL). A published pharmacokinetic-pharmacodynamic (PKPD) model for simvastatin was identified and evaluated. A model for circadian LDL production was incorporated into the PKPD model. Reduction in LDL from baseline was simulated stochastically from the full model at dose levels of 10, 20, 40 and 80 mg daily for 30 days. Simulated dosing times for each data set were morning (8.00 a.m.), evening (22.00 p.m.), evening with reduced compliance and evening for a hypothetical bioequivalent generic. Differences in LDL reduction from baseline between evening (33-43%) and morning dosing (31-43%) were negligible across a range of doses. Any differences were negated when variable compliance was considered. In addition, differences in simvastatin effect between morning and evening dosing were found to be within the range of LDL concentrations that would be permissible for a bioequivalent generic (at the lower limit) and hence are not likely to be important clinically. The results of this study suggest that taking simvastatin in the evening is not superior to morning dosing.     

老年患者用药依从性的影响因素分析及应对策略

目的探讨老年患者用药依从性影响因素及应对策略。方法对2010年6月至2011年6月于潍坊市人民医院就诊的683例老年患者采用我院自拟依从性调查问卷进行调查。结果 683例患者中用药依从性好者294例,占43.05%;而用药依从性差者389例,占56.95%。患者经常忘记服药、认为身体无不适不需再服药、担心长期用药出现药物不良反应对用药依从性影响最为明显,分别占61.05%、60.76%及59.44%。结论尽量简化老年患者用药方案、切实开展健康教育、积极倡导家庭护理及改变药物的包装、减少昂贵药物生产均有利于提高患者用药依从性。